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General NPI Number Information
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NPI Number | 1235683327
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Entity Type | Organization
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Legal Business Name | AHA LLC
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Dates
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Enumeration Date | 08/07/2016
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Last Update Date | 03/22/2017
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Provider Practice Location Address
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Address Line | 3317 PECAN SHADOW WAY
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City | MESQUITE
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State | TX
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Zip | 75181-2941
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Country | US
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Telephone | 469-803-0019
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Fax | 469-327-3007
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Provider Business Mailing Address
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Address Line | 3317 PECAN SHADOW WAY
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City | MESQUITE
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State | TX
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Zip | 75181-2941
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Country | US
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Telephone | 469-803-0019
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Fax | 469-327-3007
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Authorized Official
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Title or Position | OWNER OPERATOR
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Name | MS. SANDRA IVETTE MERENDA
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Credential |
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Telephone | 469-803-0019
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number | BGP9759
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number | JHF4367
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License Number State | TX
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